Author Interviews, Emergency Care, Nursing / 29.05.2015

Jessica Castner, PhD, RN, CEN Assistant Professor University at Buffalo, New YorkMedicalResearch.com Interview with: Jessica Castner, PhD, RN, CEN Assistant Professor University at Buffalo, New York Medical Research: What is the background for this study? Dr. Castner: There are groups of people more likely to visit the emergency department (ED) frequently.  One of these groups are people insured by Medicaid, the insurance for those with low incomes.  By finding what factors increase the risk for frequent emergency department use, healthcare leaders can target interventions to design a more effective and accessible healthcare delivery system.  With approximately 12 million ED visits each year related to behavioral health issues, we wanted to investigate how smoking, substance abuse and psychiatric diagnoses increased the risk for repeat ED use for adults insured by Medicaid. There are many problems associated with frequent emergency department use, including less than ideal continuity of care, crowding, and cost. Every year, there are over 136 million visits to United States EDs, and 12 million are linked to some sort of behavioral health issue.  Unlike primary care, the patient is not likely to see a healthcare provider in the emergency department who knows them or one who may not have access to their complete and up-to-date records.  The patient might get conflicting guidance or have tests ordered that duplicate tests recently done in other settings. Frequent emergency department visitors also contribute to crowded EDs, where demand outstrips capacity. Studies have shown an association with increased morbidity and mortality for patients treated in the ED during these times of crowding. Medical Research: What are the main findings? Dr. Castner: The main findings of our study include helping to dispel the myth of “inappropriate emergency department use.”  Our research analyzed the 2009 Medicaid claims for Erie and Niagara County. Our findings indicate that there is a positive relationship between outpatient visits and frequent emergency department use.  In other words, people who are sicker and have more complex illnesses use all services more – both the emergency department and their outpatient care provider.  In addition, we found that smoking, substance abuse, and psychiatric diagnoses all substantially increased the odds of frequent emergency department use – or ED bouncebacks.  The most surprising finding was that healthy individuals were four times more likely to be frequent ED users if they smoked. (more…)
Author Interviews, Medical Imaging, Outcomes & Safety, Pulmonary Disease, Radiology / 29.05.2015

Evgeniya Sokolovskaya, DO, MD Monmouth Medical Center Long Branch, NJ 07740.MedicalResearch.com Interview with: Evgeniya Sokolovskaya, DO, MD Monmouth Medical Center Long Branch, NJ 07740. Medical Research: What is the background for this study? What are the main findings? Dr. Sokolovskaya: As the utilization of diagnostic imaging has continued to increase in recent years, the workload of radiologists has correspondingly risen. Radiologists are under pressure to increase productivity by increasing workload volume. Previous studies have shown that increasing the number of reporting exams per day can affect the accuracy of radiologic interpretations, increase an error rate and degrade radiologists’ performance in the detection of pathology as viewing time per study decreases. The purpose of this pilot study was to determine if faster reporting speed when reading CT imaging studies of the Abdomen and Pelvis, results in higher number of misses and interpretation errors. The results of our study showed that the number of major misses and interpretation errors significantly increased at the faster reporting speed. (more…)
Author Interviews, Depression, End of Life Care, JAMA / 28.05.2015

Katherine Ornstein, PhD MPH Assistant Professor Brookdale Department of Geriatrics and Palliative Medicine Institute for Translational Epidemiology Icahn School of Medicine at Mount Sinai One Gustave L. Levy Place, Box 1070 New York, NY 10029MedicalResearch.co Interview with: Katherine Ornstein, PhD MPH Assistant Professor Brookdale Department of Geriatrics and Palliative Medicine Institute for Translational Epidemiology Icahn School of Medicine at Mount Sinai New York, NY 10029 Medical Research: What is the background for this study? What are the main findings? Dr. Ornstein: There is an increased focus on the need to support caregivers and families, particularly at the End of Life (EOL). They play a critical role in the care process and decision making, yet this can be a very high stress role with an increased risk for negative consequences. Hospice services, which are increasing, are focused on palliative rather than curative care and include medical services, symptom management, spiritual counseling, social services and bereavement counseling delivered by an interdisciplinary team of professionals for dying patients.  An important part of the hospice service is the provision of support to families during illness and after death.  Prior research suggests that hospice (which is cost saving, has benefits to patients), may also  be beneficial to families. Yet these studies have been largely limited to patients with cancer, have failed to adequately control for differences between patients who do or do not use hospice. Overall, there was an increase in depressive symptoms after death.  However, surviving spouses of those who used hospice were more likely to have a decrease in depressive symptoms. We found that the positive benefit of hospice was much stronger when we looked at least 1 year after death. (more…)
ALS, Author Interviews, Mayo Clinic, Science / 28.05.2015

Dr. Leonard Petrucelli Ph.D Mayo Clinic Jacksonville, FL 32224MedicalResearch.com Interview with: Dr. Leonard Petrucelli Ph.D Mayo Clinic Jacksonville, FL 32224 MedicalResearch: What is the background for this study? Dr. Petrucelli: According to the ALS Association, more than 30,000 Americans live with amyotrophic lateral sclerosis (ALS), a condition that destroys motor neuron cells that control essential muscle activity such as speaking, walking, breathing and swallowing. After Alzheimer’s disease, frontotemporal dementia (FTD) is the most common form of early onset dementia. It is characterized by changes in personality, behavior, and language due to loss of neurons in the brain’s frontal lobe. Once considered rare, frontotemporal dementia is now thought to account for up to 10 to 15 percent of all dementia cases, according to the Alzheimer’s Association. In 2011, Mayo investigator Rosa Rademakers, Ph.D., identified the most common genetic mutation known to cause ALS and FTD, namely a repeat expansion in the gene C9ORF72. The C9ORF72 repeat expansion leads to the generation of toxic RNA species that form abnormal foci, as well as inclusions of c9RAN proteins in affected cells in the central nervous system. Prior to this research study lead by Leonard Petrucelli, Chair of the Department of Neuroscience at the Mayo Clinic Florida, no animal model existed that fully recapitulated the known clinicopathological features of what is now collectively referred to as c9FTD/ALS. Without such an animal it has remained difficult to identify important mechanisms by which the repeat expansion leads to neurodegeneration and putative therapeutic targets that may mitigate disease in patients where currently there are no curative treatments. (more…)
Alcohol, Author Interviews, BMJ, Heart Disease, Women's Heart Health / 27.05.2015

Alexandra Gonçalves, MD, PhD Postdoctoral Research Fellow Cardiovascular Department Brigham and Women's Hospital Boston, MA 02115MedicalResearch.com Interview with: Alexandra Gonçalves, MD, PhD Postdoctoral Research Fellow Cardiovascular Department Brigham and Women's Hospital Boston, MA 02115 MedicalResearch.com: What is the background for this study? Dr. Gonçalves: Excessive alcohol consumption is associated with alcoholic cardiomyopathy, while light to moderate drinking might have benefits in the risk of heart failure (HF). However, the cardiovascular mechanisms and the alcohol dosage associated with risks or potential benefits are uncertain. Furthermore, the variation in the toxic and protective effects of alcohol by sex remains controversial, as women may be more sensitive than men to the toxic effects of alcohol on cardiac function, developing alcoholic cardiomyopathy at a lower total lifetime dose of alcohol compared to men. In this study we assessed the associations between alcohol intake and cardiac structure and function by echocardiography, in elderly men and women in the large, community-based Atherosclerosis Risk in Communities (ARIC) Study. MedicalResearch.com: What are the main findings? Dr. Gonçalves: We studied 4466 participants (76±5 years and 60% women) with alcohol consumption ascertained, who underwent transthoracic echocardiography. Participants were classified into 4 categories based on self-reported alcohol intake: non-drinkers, drinkers of up to 7 drinks per week, ?7 to 14 and ? 14 drinks per week. In both genders, increasing alcohol intake was associated with larger left ventricular (LV) diastolic and systolic diameters and larger left atrial diameter. In men, increasing alcohol intake was associated with greater LV mass and higher E/E’ ratio. In women, increasing alcohol intake was associated with lower LV ejection fraction. (more…)
Author Interviews, BMJ, OBGYNE, Pharmacology, Thromboembolism / 27.05.2015

MedicalResearch.com Interview with: Yana Vinogradova, Research Fellow Division of Primary Care School of Medicine University of Nottingham Medical Research: What is the background for this study? What are the main findings? Response: Combined oral contraceptives are an effective method of birth control but do have measurable side effects.  One – common to all combined contraceptives and sometimes fatal – is an increased risk of venous thromboembolism (VTE).  A number of earlier studies investigated VTE risks for different types of hormonal contraceptives, but all were performed some years ago or had insufficient data to analyse newer preparations, while some included only healthy users and others did not adequately control for lifestyle and health issues.  The data used for this study were representative of the UK population and covered all currently prescribed drugs, with results adjusted for the widest possible range of available relevant factors. We found that the venous thromboembolism risks of combined oral contraceptives appear to fall into two distinct groups.  Newer drugs containing gestodene, desogestrel, drospirenone or cyproterone were associated with risks of VTE between 1.5 and 1.8 times higher than both the older compositions containing norethisterone or levonorgestrel and the relatively newer norgestimate.  While our findings are statistical associations between different compositions and venous thromboembolism risks, they do represent more comprehensive and reliable information for doctors making evidence-based prescribing decisions. (more…)
Asthma, Author Interviews, JAMA, Nutrition / 27.05.2015

Lewis J. Smith, MD Professor of Medicine and Associate Vice President for Research Northwestern University and the Feinberg School of Medicine Chicago, IL 60611MedicalResearch.com Interview with: Lewis J. Smith, MD Professor of Medicine and Associate Vice President for Research Northwestern University and the Feinberg School of Medicine Chicago, IL 60611 Medical Research: What is the background for this study? What are the main findings? Dr. Smith: We previously observed in a survey of more than 1,000 patients with asthma that those consuming soy isoflavones in their diet had better lung functioning than their counterparts who consumed little or none.  Using a more detailed soy questionnaire, we confirmed the observation in a different group of patients with asthma, and followed that up with laboratory studies.  In cell culture studies, we saw that genistein, the major soy isoflavone, at levels that are achieved in individuals consuming a high soy diet, reduces eosinophilic inflammation, a key feature in asthma. In addition, people who consume more soy products, mostly in Japan and parts of China, generally have less asthma than in western countries.  Although these data indicate a potential beneficial effect of soy isoflavones in patients with asthma and nutritional supplements are commonly used by people to treat and prevent disease and improve their health, there was little direct data to prove that the supplement is actually effective.  As a result, we explored the effects of a soy isoflavone supplement in 386 adults and children aged 12 or older with poorly controlled asthma. All were taking medicine to treat their asthma – either corticosteroids or leukotriene modifiers – but none consumed soy more than once a week. In the randomized, double-blind study, half of the participants took a soy isoflavone supplement twice daily for six months, and the other half took a placebo. We found that the supplement, though able to increase blood levels of genistein, did not improve lung function, symptoms or measures of inflammation in these individuals. (more…)
Author Interviews, Biomarkers, Nature, Prostate Cancer, Technology / 27.05.2015

Gabriel Popescu PhD Associate Professor Department of Electrical and Computer Engineering & Bioengineering University of Illinois at Urbana-Champaign Beckman Institute for Advanced Science and Technology Urbana, IL 61801MedicalResearch.com Interview with: Gabriel Popescu PhD Associate Professor and Shamira Sridharan, Ph.D. candidate Quantitative Light Imaging Laboratory, Department of Bioengineering, Beckman Institute for Advanced Science and Technology University of Illinois at Urbana Champaign Urbana, IL Medical Research: What is the background for this study? What are the main findings? Dr. Popescu: We developed a new optical tool that can identify patients at high risk for recurrence of prostate cancer after undergoing radical prostatectomy as treatment.  Early identification of risk for recurrence can allow early treatment of disease. Our main finding was that among individuals with worse disease outcomes, the tissue is more disorganized.  This manifests as a decrease in anisotropy, or light scattering angle, which reports on nano-scale differences in tissue architecture. (more…)
Author Interviews, Kidney Stones / 27.05.2015

Dr. Michael Bailey, Ph.D. Senior Principal Engineer Assistant Professor, Mechanical Engineering and Adjunct Assistant Professor, Urology University of WashingtonMedicalResearch.com Interview with: Dr. Michael Bailey, Ph.D. Senior Principal Engineer Assistant Professor, Mechanical Engineering and Adjunct Assistant Professor, Urology University of Washington Medical Research: What is the background for this study? What are the main findings? Dr. Bailey: Ultrasonic propulsion is a new technology that uses focused ultrasound energy to reposition kidney stones transcutaneously. We report the findings from the first human investigational trial of ultrasonic propulsion toward the applications of expelling small stones and dislodging large obstructing stones. Subjects underwent ultrasonic propulsion either awake without sedation or during ureteroscopy while anesthetized. A pain questionnaire was completed before, during, and after propulsion for awake subjects. Potential adverse events were assessed weekly for 3 weeks after propulsion for all subjects. The primary outcome was to reposition stones in the collecting system. Secondary outcomes included safety, controlled movement of stones, and movement of stones < 5 mm and ≥ 5 mm. Stones were localized and repositioned in 14 of 15 enrolled subjects. Of the 43 targets, 28 (65%) showed some level of movement while 13 (30%) were displaced to a new location > 3 mm. No adverse events were reported. Mild discomfort during the procedure was rare, brief, and self-limited. Stones were moved in a controlled direction with over 30 fragments being passed by most patients who previously had a lithotripsy procedure. The largest stone moved was 10 mm. One patient experienced pain relief during treatment of an obstructing stone. In 4 subjects a seemingly large stone, which might have required surgery, was determined to be a cluster of small passable stones. (more…)
Author Interviews, Coffee, Erectile Dysfunction, PLoS, University Texas / 26.05.2015

David S. Lopez, Dr.P.H., M.P.H. Assistant professor University of Texas Health School of Public HealthMedicalResearch.com Interview with: David S. Lopez, Dr.P.H., M.P.H. Assistant professor University of Texas Health School of Public Health Medical Research: What is the background for this study? What are the main findings? Dr. Lopez: Coffee, and its most studied component, caffeine, have been implicated in potential health benefits due to the rich sources of antioxidants and anti-inflammatory compounds contained in this beverage. Caffeine intake reduced the odds of prevalent erectile dysfunction, especially an intake equivalent to approximately 2-3 daily cups of coffee (170-375 mg/day). This reduction was also observed among overweight/obese and hypertensive men, but not among diabetic men. These associations are warranted to be investigated in prospective studies. Medical Research: What are the main findings? Dr. Lopez: Caffeine intake reduced the odds of prevalent erectile dysfunction, especially an intake equivalent to approximately 2-3 daily cups of coffee (170-375 mg/day). This reduction was also observed among overweight/obese and hypertensive men, but not among diabetic men. These associations are warranted to be investigated in prospective studies. (more…)
Author Interviews, Dermatology, JAMA / 26.05.2015

MedicalResearch.com Interview with: Robert E Kalb, M.D. Clinical Professor of Dermatology State University of New York at Buffalo School of Medicine and Biomedical Sciences Buffalo Medical Group, P.C. Buffalo, NY 14221MedicalResearch.com Interview with: Robert E Kalb, M.D. Clinical Professor of Dermatology State University of New York at Buffalo School of Medicine and Biomedical Sciences Buffalo Medical Group, P.C. Buffalo, NY 14221 Medical Research: What is the background for this study? What are the main findings? Dr. Kalb: It's important to evaluate the safety of biologics in the real world post-marketing setting, and in particular with respect to serious infections. We studied patients with psoriasis in the PSOLAR registry and evaluated the risk of various biologic therapies. We found that infliximab and adalimumab were associated with increased risk of serious infections when compared with non-biologic/non-methotrexate therapies, while ustekinumab and etanercept were not associated with increased risk. (more…)
Author Interviews, Cancer Research, Chemotherapy, JNCI, MD Anderson, Ovarian Cancer / 26.05.2015

Wei Zhang, Ph.D., Professor Department of Pathology Director, Cancer Genomics Core Lab University of Texas MD Anderson Cancer Center Houston, Texas 77030MedicalResearch.com Interview with: Wei Zhang, Ph.D., Professor Department of Pathology Director, Cancer Genomics Core Lab University of Texas MD Anderson Cancer Center Houston, Texas 77030 Medical Research: What is the background for this study? What are the main findings? Dr. Zhang: Epithelial ovarian cancer remains the most lethal gynecological malignancy. The 5-year survival rate for patients with advanced ovarian cancer is only 30-40%, and acquired resistance to platinum is considered a major factor in disease relapse. A major challenge in cancer treatment is the resilient ability of cancer cells to repair DNA damage caused by chemotherapy agents.  In this study, we found that adding a molecule called miR-506 to standard chemotherapy can help cells overcome drug resistance, so that the chemotherapy drugs remain effective against ovarian cancer. This research supports a new combination approach, which may substantially benefit patients with this deadly disease. (more…)
Author Interviews, Diabetes, Nature, Neurological Disorders, Vegetarians / 26.05.2015

Ulka Agarwal, M.D. California State University, East Bay Student Health and Counseling Services, Hayward, MedicalResearch.com Interview with: Ulka Agarwal, M.D. California State University, East Bay Student Health and Counseling Services Hayward, CA MedicalResearch: What is the background for this study? What are the main findings? Dr. Agarwal: Diabetic peripheral neuropathy affects 60 percent of patients with type 2 diabetes and can come with painful symptoms but limited treatment options. We thought a dietary intervention may help alleviate these symptoms since glycemic control plays a role in diabetes complications. To get started with the pilot, we put 17 adults on a low-fat vegan diet for 20 weeks and prescribed weekly nutrition classes. We found significant improvements in pain, measured by the Short Form McGill Pain questionnaire, the Michigan Neuropathy Screening Instrument physical assessment, and through electrochemical skin conductance in the foot. The participants also lost an average of 14 pounds. (more…)
Author Interviews, Cancer Research, JAMA, Toxin Research / 26.05.2015

MedicalResearch.com Interview with: Catterina Ferreccio, MD, MPH School of Medicine Pontificia Universidad Católica de Chile Santiago, Chile Medical Research: What is the background for this study? What are the main findings? Dr. Ferreccio: In Chile, gallbladder cancer (GBC) is the 2nd highest cause of cancer death in women.  Other than gallstones no other causal factors have been identified. We conducted a pilot case-control study of gallbladder cancer to evaluate its association with aflatoxin B1 (AFB1) exposure. Aflatoxins are toxics products of the fungis Aspergillus flavus and Aspergillus parasiticus and are contaminants of food; AFB1 is carcinogenic. Usually they are found in areas closer to the Equator than Chile. Main findings were the high proportion (35%) of study subjects carrying aflatoxins adducts and the particularly high exposure among the Gallbladder cancer (GBC) cases (64%) compared with gallstones controls (18%) or with population controls (23%). Difference of gallbladder cancer vs controls were statistically significant and suggests aflatoxins may be a significant risk factor for gallbladder cancer; hypothesis never tested before. (more…)
Author Interviews, Genetic Research, JAMA / 26.05.2015

Prof. Alexandre Reymond Director, Center for Integrative Genomics University of Lausanne Lausanne SwitzerlandMedicalResearch.com Interview with : Prof. Alexandre Reymond Director, Center for Integrative Genomics University of Lausanne Lausanne Switzerland MedicalResearch : What is the background for this study? Prof. Reymond: Though a subset of recurrent DNA copy number variants (differing numbers of copies of genetic sequence at locations in the genome; CNVs) with rare population prevalence are known to have strong impact on carrier’s health, up to now their association with phenotypes such as intellectual disability has been almost exclusively evaluated in clinical context using individuals ascertained for diagnostics of developmental disorders. Thus the contribution of these genetic variants to health, cognition and life quality in the general population remains unclear. We used a population biobank, that of Estonia (Estonian Genome Center, University of Tartu), which contains samples from 52,000 adult participants (representative 5% of the country’s adult population), a British birth cohort (The Avon Longitudinal Study of Parents and Children; ALSPAC) and two more population-based cohorts from the USA and Italy to explore the consequences of CNVs in presumptively healthy populations. MedicalResearch : What are the main findings? Prof. Reymond: Rare recurrent CNVs known to be causative for specific syndromes (termed genomic disorders) have a global population prevalence of around 1%. Contrary to popular assumption that carriers of these syndromic CNVs identified in unselected, but assumed to be healthy, adult population cohorts are asymptomatic, we found that they are associated with unrecognized, but serious clinical sequelae. Additionally our results showed that individually rare (less than 1 in 2000 individuals) but collectively common (around 10% of population) intermediate-size CNVs are negatively associated with carriers’ educational attainment. Altogether our results suggest that the life quality of at least 1 of 40 people might be negatively affected by rare CNVs. (more…)
Author Interviews, Breast Cancer / 26.05.2015

Professor Ramsey Cutress Associate Professor in Breast Surgery University of SouthamptonMedicalResearch.com Interview with: Professor Ramsey Cutress Associate Professor in Breast Surgery University of Southampton Medical Research: What is the background for this study? What are the main findings? Response: The main finding is that in young women with breast cancer, a breast cancer family history of breast cancer did not affect recurrence rates. This work forms part of the Prospective Outcomes in Sporadic versus Hereditary breast cancer (POSH) study, which included 2850 women under age 41 years who were diagnosed with breast cancer and treated in the UK. The study, led by principal investigator Professor Diana Eccles, recorded patients’ personal characteristics, tumour characteristics, treatment, and family history of breast/ovarian cancer over a 15-year period. (more…)
Author Interviews, Cognitive Issues, Infections, PLoS / 24.05.2015

Dr. Michael Eriksen Benrós Mental Health Centre Copenhagen University of Copenhagen Faculty of Health Sciences Copenhagen NV, Denmark, National Centre for Register-based Research Aarhus University DenmarkMedicalResearch.com Interview with: Dr. Michael Eriksen Benrós Mental Health Centre Copenhagen University of Copenhagen Faculty of Health Sciences Copenhagen NV, Denmark, National Centre for Register-based Research Aarhus University Denmark Medical Research: What is the background for this study? Response: It is increasingly recognized that infections and immune responses can affect the brain and activate immunocompetent cells within the brain, influencing on neuronal signal transduction and possibly cognition. Impaired cognition has been observed in association with several infections and with elevated levels of CRP in smaller studies. Furthermore, experimental activation of inflammatory reactions in healthy volunteers has been shown to induce short-term reduced cognitive performance. Moreover, particularly patients with infection in the brain or sepsis have been shown to have affected cognition in long time periods after the infection has been cleared, thus infections might also have a longer lasting effect on cognition. However, large-scale longitudinal studies had been lacking on the association between infections and cognitive ability in the general population. Medical Research: What are the main findings? Response: Our study is the first large-scale study utilizing the extensive Danish registers to follow 190,000 males that had their IQ assessed at conscription, out of which 35% had a previous hospital contact with infection before the IQ testing was conducted. Our research shows a correlation between severe infections with a hospital contact and subsequent impaired cognition corresponding to an IQ score of 1.76 lower than the average. People with five or more hospital contacts with infections had an IQ score of 9.44 lower than the average. The study thus shows a clear dose-response relationship between the number of infections. Furthermore the effect on cognitive ability increased with the temporal proximity of the last infection and with the severity of the infection. Infections in the brain affected the cognitive ability the most, but many other types of infections severe enough to require a hospital contact where also associated with impairment of the cognitive ability. (more…)
Author Interviews, Blood Pressure - Hypertension, Geriatrics, Kidney Disease / 24.05.2015

Enayet Karim Chowdhury, Research Fellow Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University The Alfred Centre Melbourne VIC 3004MedicalResearch.com Interview with: Enayet Karim Chowdhury, Research Fellow Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University The Alfred Centre Melbourne VIC 3004 Medical Research: What is the background for this study? What are the main findings? Dr. Chowdhury: The study was conducted on elderly treated hypertensive population. Australia is currently undergoing a demographic transition towards having increasing number of older people. As age advances quality of life becomes increasingly affected by a variety of chronic diseases including poor renal function. Therefore early detection and management of the risk associated with these chronic diseases is crucial. Managing hypertension, even though challenging, can significantly improve quality of life of a person by reducing risk of having cardiovascular events. The main finding of the study is that in elderly treated hypertensive people, a rapid decline in renal function was associated with a higher risk of having cardiovascular events irrespective of having chronic kidney disease or not. (more…)
Author Interviews, Pediatrics / 23.05.2015

Dr. Simon Cheng PhD. Department of Sociology University of Connecticut, Storrs, CTMedicalResearch.com Interview with: Dr. Simon Cheng PhD. Department of Sociology University of Connecticut, Storrs, CT Medical Research: What is the background for this study? What are the main findings? Dr. Cheng: Our research is an empirical response to the Regnerus study, one of the most visible and controversial articles ever published in the social sciences.  His study concluded that individuals raised by a gay or lesbian parent display less favorable adulthood outcomes than those who grew up in intact biological families.  There have been many debates about the study’s conclusion and analysis, but we (Cheng and Powell) are the first to reassess Regnerus’s findings by analyzing his own data.  Our reanalysis seriously calls into question his conclusions. We find that a large number of the people studied in the Regnerus study likely were misclassified as living with gay/lesbian parents.  The misclassifications took several forms:
  • Of the 236 people Regnerus defined as being raised by a “lesbian mother” or “gay father’ 24 (10%) report that they actually never lived with that parent
  • An additional 34 (14%) report that they lived with that parent for a year of less.
  • The 236 people include some questionable responses that lead us to doubt the seriousness of the person completing the survey. The most notable example is a 25 year-old man who reports that his father had a romantic relationship with another man, but also reports that he (the respondent) was 7-feet 8-inches tall, weighted 88 pounds, was married 8 times, and had 8 children.  Another person claims to have been arrested at age 2.
  • The 236 people also include responses that at best are inconsistent and illogical.  For example, one person repots “having always live alone but also claims to have always lived with the mother, father, and two grandparents.”
After reviewing each case, we demonstrated that at least one-third and up to two-fifths were miscounted by Regnerus as having been raised by gay or lesbian parents. Regnerus’s disputable findings are due to these misclassifications and other questionable methodological choices.  When the analyses are more carefully done, our results show minimal differences between young adults who were raised by gay and lesbian parents and young adults who were raised by heterosexual parents. (more…)
Author Interviews, Microbiome, Pediatrics / 23.05.2015

MedicalResearch.com Interview with: Ms. Pajau Vangay Graduate Research Fellow Biomedical Informatics and Computational Biology Vice President of Grants, Council of Graduate Students University of Minnesota Medical Research: What is the background for this study? What are the main findings? Response: Previous studies showed links between antibiotic use and unbalanced gut bacteria, and others showed links between unbalanced gut bacteria and adult disease. Over the past year we synthesized hundreds of studies and found evidence of strong correlations between antibiotic use, changes in gut bacteria, and disease in adulthood. (more…)
Accidents & Violence, Author Interviews / 23.05.2015

Marie Crandall, MD, MPH, FACS Associate Professor of Surgery Northwestern University Feinberg School of Medicine Chicago, IL 60611MedicalResearch.com Interview with: Marie Crandall, MD, MPH, FACS Associate Professor of Surgery Northwestern University Feinberg School of Medicine Chicago, IL 60611   Medical Research: What is the background for this study? What are the main findings? Dr. Crandall: While the association between alcohol and interpersonal violence has been well established, research has been divided with respect to the direct effect of proximity to an establishment with a liquor license and violence.  We used geographic regression analysis, which is a type of multivariate regression including geography as a variable, to examine the association between proximity to an establishment with a liquor license, such as a liquor store or tavern, and gun violence in Chicago. We utilized our state trauma registry and geocoded 11,744 gunshot wounds that occurred between 1999-2009.  On the assumption that different neighborhoods might experience risk differently, we used a combination of ordinary least squares and geographic regression analysis to identify homogenous areas with similar risk.  We used sociodemographic variables as covariates in the analysis. We found that the impact of proximity to an establishment with a liquor license and occurrence of gunshot wounds varied markedly by neighborhood.  The areas of highest risk were found to have enormous associations, Odds Ratios (OR) greater than 500.  These areas also tended to be more socioeconomically distressed areas of the city. (more…)
Author Interviews, Diabetes, Genetic Research, Weight Research / 22.05.2015

MedicalResearch.com interview Dorota Kaminska, MSc Department of Clinical Nutrition University of Eastern Finland MedicalResearch: What is the background for this study? What are the main findings? Response: The prevalence of obesity is increasing worldwide, making it one of the biggest health problems currently facing both developed and developing countries. Obesity is considered a primary risk factor for developing type 2 diabetes. While the majority of people with type 2 diabetes are obese, most of obese people do not develop diabetes, indicating that obesity is not the only risk factor for type 2 diabetes. Both obesity and type 2 diabetes are multifactorial complex diseases that are caused by a combination of genetic, environmental, and lifestyle factors. Results from twin studies suggest that genetic factors explain 50% to 90% of the variance in body mass index (BMI) and from 45% to 85% of the diabetes risk. However genetic variations identified by genome wide association studies (GWAS) explain only 2-4% of the obesity risk and 5-10% of the type 2 diabetes risk. Several options have been debated to be a source of so called “missing heritability”, including, among others, structural DNA variations, gene-gene and gene-environment interactions, epigenetic modifications and RNA splicing. We used adipose tissue samples from Kuopio Obesity Surgery (KOBS), very low calorie diet (VLCD), Metabolic Syndrome in Men (METSIM) and European Network on Functional Genomics of Type 2 Diabetes (EUGENE2) studies to determine alternative splicing pattern of selected genes. The study focused on determining the effects of obesity and weight loss on alternative splicing of metabolically active genes (TCF7L2 and INSR). We showed that alternative splicing of both genes is dysregulated in obesity and type 2 diabetes, resulting in impaired insulin action in adipose tissue. Additionally we demonstrated, that obesity induced changes in splicing can be reversed by weight loss induced by gastric bypass surgery or very low calorie diet. Furthermore, the study identified alternatively spliced genes in the genomic regions associated with obesity risk, demonstrating that splicing of the MSH5 gene in subcutaneous fat is regulated by weight loss. The study also found that body mass index is a main determinant of TRA2B, BAG6 and MSH5 splicing in subcutaneous fat; however, the functional consequences of this finding require further investigation. These findings imply that the obesity-associated gene variants might act through regulation of splicing which in turn might underlie the pathogenesis of obesity in individuals carrying the risk variants. (more…)
Author Interviews, Lancet, Ovarian Cancer, Surgical Research / 22.05.2015

MedicalResearch.com Interview with: Mr Matthew Nankivell MRC Clinical Trials Unit at University College London Institute of Clinical Trials and Methodology Aviation House, London UK Medical Research: What is the background for this study? What are the main findings? Response: Ovarian cancer is diagnosed in over 7000 women each year in the UK. Over 75% of these already have advanced disease, for which the standard treatment is surgery followed by platinum based chemotherapy. The prognosis for these patients remains poor however, with less than 25% surviving for 5 years. There is consistent evidence that achieving optimal debulking (meaning less than 1cm of residual tumour after surgery) is key to increasing survival. The theory tested in Chorus is that giving the chemotherapy before surgery (neo-adjuvantly) would be as least as effective as giving it post-operatively, and may in fact increase the chance of achieving optimal debulking, and subsequently living for longer. In Chorus we randomised 552 women to receiving either the current standard of immediate surgery followed by chemotherapy, or chemotherapy followed by surgery. The trial met its primary aim of showing that neo-adjuvant chemotherapy was no worse than post-operative chemotherapy, with median survival times of 24.1 and 22.6 months respectively. The proportion of women achieving optimal debulking increased from 41% in the post-operative chemotherapy group to 73% in the neo-adjuvant chemotherapy group. Additionally we saw that fewer women experienced serious post-operative complications having had neo-adjuvant chemotherapy (14% vs 24%), and fewer women died within 28 days of surgery (<1% vs 6%). There is a planned meta-analysis, to combine the data from Chorus with those from a similar European trial, which will allow further investigations to take place, and may allow the identification of groups of women who are more likely to benefit from one or other of the approaches. (more…)
Author Interviews, Lifestyle & Health, Menopause / 22.05.2015

MedicalResearch.com Interview with: Jasmine Lee, M.Sc. and Chris I. Ardern, Ph.D. School of Kinesiology and Health Science York University Toronto, ON, Canada Medical Research: What is the background for this study? Response: Although the benefits of physical activity are well known, the health and mortality risks associated with sedentary time (activities <1.5 MET)—which can occur in long, continuous bouts, such as at the workplace, during motorized transportation and via screen time— have been less frequently explored, and may differ across subgroups of the population. Like physical activity, sedentary time may fluctuate with major life events and occupation (e.g. aging, retirement, etc.), which raises the question of the short-term relationship between changes in sitting time and mortality risk. Medical Research: What are the main findings? Response: Maintenance of minimal sedentary time, as well as short-term reduction in sedentary time, were found to reduce the risk of all-cause and cancer- mortality amongst a sample of middle-aged and older women (50-79 y) who are prone to high rates of physical inactivity and sedentary time. (more…)
Author Interviews, OBGYNE, Pediatrics, Race/Ethnic Diversity / 22.05.2015

Katherine Jones, M.A. Research Associate, Department of Research The American College of Obstetricians and Gynecologists Department of Psychology, American UniversityMedicalResearch.com Interview with: Katherine Jones, M.A. Research Associate, Department of Research The American College of Obstetricians and Gynecologists Department of Psychology, American University Medical Research: What is the background for this study? What are the main findings? Response:  It is well evidenced that breastfeeding is highly advantageous for the mother, child, and society. Benefits to breastfeeding may be significantly larger for minority women as they are disproportionately affected by numerous adverse health outcomes. The benefits of breastfeeding may help mitigate some of these negative health consequences, and thus, also bridge larger gaps in racial and ethnic health disparities. This article aimed to review the literature on racial and ethnic disparities in breastfeeding rates and practices, conduct a systematic review of breastfeeding interventions, address barriers to breastfeeding among minority women, and provide obstetrician-gynecologists (ob-gyns) with recommendations on how they can help improve rates among minority women. Overall, racial and ethnic minority women continue to have lower breastfeeding rates than white women in the United States, with African American women having the lowest rates of breastfeeding initiation and continuation among to all women. Minority women report several unique barriers to breastfeeding, including lack of access to information that promotes and supports breastfeeding, lack of work and cultural acceptance and support, language and literacy barriers, acculturation, and historical, sociopolitical, and economic challenges. Results from the systematic review of breastfeeding interventions among minority women indicated that breastfeeding-specific clinic appointments, enhanced breastfeeding programs, group prenatal education, peer counseling, and hospital policy changes significantly improve breastfeeding initiation, duration, and exclusivity. (more…)
Author Interviews, Biomarkers, Colon Cancer / 22.05.2015

Dr. Jeanne Tie Medical Oncologist | Royal Melbourne and Western Hospital Research Fellow Walter and Eliza Hall Institute of Medical Research Parkville, VICMedicalResearch.com Interview with: Dr. Jeanne Tie Medical Oncologist | Royal Melbourne and Western Hospital Research Fellow Walter and Eliza Hall Institute of Medical Research Parkville, VIC Medical Research: What is the background for this study? Dr. Tie: The increasing number of active agents available to treat metastatic colorectal cancer has resulted in an ever-improving life expectancy in this group of patients. However, the ability to expose patients with metastatic colorectal cancer to all effective anti-cancer treatment, particularly 3rd line treatment and beyond, is increasingly challenging in routine practice as some patients’ condition deteriorate too rapidly and do not live long enough to enjoy the benefit of these additional therapies. This is partly due to the current imaged-based method of assessing treatment response with the Response Evaluation Criteria in Solid Tumors (RECIST), which is usually performed every 8-12 weeks during the course of treatment. This means that for non-responders to treatment, several weeks to months will elapse before a switch to alternative therapy will be made. Conceptually, if a patient’s response to treatment could be made earlier, such as with a blood test,  then an earlier switch to an alternative treatment can be made, minimizing the side-effects of the ineffective therapy and providing the opportunity for a more effective one. Currently, blood biomarkers add little to imaging-based assessment, with CEA lacking sensitivity and specificity. Colorectal cancer is characterised by several recurrently mutated genes and advances in genomics and molecular technologies have now enabled rapid detection and quantification of these cancer-specific mutations in patient’s circulation (circulating tumor DNA - ctDNA). Previous studies have demonstrated that ctDNA can be detected in a high proportion of patients with advanced cancer. In this study, we describe the potential role of ctDNA as an early predictor of treatment response in patients with treatment naïve metastatic colorectal cancer (mCRC) undergoing chemotherapy and as a marker of disease bulk that could complement RECIST measurement. (more…)
Author Interviews, HIV, NYU, Race/Ethnic Diversity, Sexual Health / 22.05.2015

Perry N Halkitis, Ph.D., M.S., MPH Professor of Applied Psychology Global Public Health, and Population Health/Medicine New York University.MedicalResearch.com Interview with: Perry N Halkitis, Ph.D., M.S., MPH Professor of Applied Psychology Global Public Health, and Population Health/Medicine New York University. Medical Research: What is the background for this study? Dr. Halkitis: The P18 Cohort Study is a prospective cohort study of gay, bisexual and other young men who have sex with men (YMSM) which seeks to examine the development of health behaviors as these young men transition from adolescent to adulthood. Officially named “Syndemic Production among Emergent Adult Men”, this study was funded by the National Institute on Drug Abuse from 2009-2014 and renewed on March 1, 2014 for an additional five years. The original aims of the study were as follows:
  • 1) to develop and test theoretically informed measurement models of the covariance of illicit drug use, unprotected sexual behavior and mental health burden (multiple overlapping epidemics known as a syndemic) among emergent adult HIV-negative YMSM within and across time;
  • 2) to delineate the risk and protective bases- physical factors (e.g., pubertal onset, HIV status, etc.), relational and structural factors (e.g., family history of psychopathology, current romantic relationships, peer support, neighborhood factors, etc.), and psychosocial factors (e.g., sexual identity, internalized homophobia, hyper-masculine conceptions, etc.) that predict the development of syndemics; and
  • 3) to determine the extent to which the development of a syndemic varies by race/ethnicity, social class, and homelessness/housing instability.
  • In this current five year continuation we also seek
    • 1) to describe the social and sexual networks of YMSM, and to examine the relationship between social and sexual network-level structural characteristics, social support and normative influences on syndemic production (illicit drug use, unprotected sexual behaviors, and mental health burden) in YMSM, singly and in combination with the physical, psychosocial, and relational predictors, both within and across time;
    • 2) to describe the acquisition of sexually transmitted infections (STIs) in YMSM, specifically, urethral and rectal gonorrhea and chlamydia, pharyngeal gonorrhea as well as syphilis serology; and to determine the extent to which physical, relational, and psychosocial factors explain STI acquisition as part of the syndemic model within and across time.
    • A third exploratory aim was also added: 3) to describe HIV clinical treatment markers (i.e., HIV viral load, ART uptake and adherence, HIV care) among HIV+ YMSM, and to assess the extent to which physical, relational, and psychosocial factors are associated with differences in these clinical markers among HIV+ YMSM, both within and across time. The study is led by Drs. Perry N Halkitis and Farzana Kapadia at New York University’s Center for Health, Identity, Behavior & Prevention Studies.
Potential participants were recruited through both active (e.g., approaching individuals to solicit study participation) and passive (e.g., flyer posting, website advertisements) methods from June 2009 to May 2011. Eligibility criteria included being 18-19 years old, biologically male, residing in the NYC metropolitan area, having sex (any physical contact that could lead to orgasm) with a man in the last 6 months, and reporting a seronegative or unknown HIV status at baseline. We ensured the diversity of our sample by setting a fixed recruitment quota for participants in each targeted racial/ethnic group, such that African Americans, Latino (across race), Asian-Pacific Islander (API), and mixed race men comprised the majority of the sample. All participants provided written, informed consent before data was collected and were compensated for their time and effort upon completing the baseline assessment. The New York University’s Institutional Review Board (IRB) approved all study protocols and a federal Certificate of Confidentiality protects these data. A total of 2,068 participants were screened for eligibility to participate in the study, and 600 participants completed the baseline assessment in the first wave of the study. In 2014, we began the second wave and opened to cohort to recruit a baseline sample of 650 YMSM who will now be between the ages of 22-23; recruitment of participants is still underway. Medical Research: What are the main findings? Dr. Halkitis: Numerous publications have been generated from the P18 Cohort Study and can be accessed at www.chibps.org.  A recent publication, “Incidence of HIV infection in Young Gay, Bisexual, and other YMSM: The P18 Cohort Study” became available in the May 2015 of JAIDS, the Journal of Acquired Immune Deficiency Syndromes. This paper reports that over a 36 month follow-up period, during the first wave of the study, 7.2% of study participants seroconverted, with Black and Hispanic men much more likely to seroconvert over this time frame than White men. This finding aligns with epidemiological trends for HIV infection at the national and local, NYC, levels. Also, men reporting a lower familial socioeconomic status were more likely to seroconvert than men reporting high familial socioeconomic status, and Black men were more likely to report a lower socioeconomic status.  Moreover, the Black young men who seroconverted were more likely to reside in neighborhoods with higher area-level poverty and higher area-level HIV prevalence. Additionally we found that men who reported anal sex without a condom in the 30 days prior to assessment were no more likely to seroconvert than those who reported sex with a condom.  However, an earlier age of sexual debut was a predictor of HIV seroconversion. (more…)
AHA Journals, Author Interviews, Heart Disease, Metabolic Syndrome, Race/Ethnic Diversity, Weight Research / 21.05.2015

Michelle Schmiegelow, MD, PhD-studerende Hjertemedicinsk Forskning Gentofte Universitetshospital HellerupMedicalResearch.com Interview with: Michelle Schmiegelow, MD, PhD-student Hjertemedicinsk Forskning Gentofte Universitetshospital Hellerup Medical Research: What is the background for this study? Dr. SchmiegelowObesity has become a worldwide epidemic, but the excess cardiovascular risk observed in obese individuals may primarily be attributable to metabolic mediators, rather than obesity per se. Several studies conducted in primarily non-Hispanic white populations suggest that obese individuals without the metabolic syndrome, defined as metabolically healthy obese, have a cardiovascular risk similar to that of normal weight metabolically healthy individuals. We used prospectively collected data from the Women’s Health Initiative studies to evaluate whether obesity unaccompanied by metabolic abnormalities was associated with increased risk of cardiovascular disease (CVD) across racial/ethnic subgroups in postmenopausal women. Additionally, we examined whether the use of the metabolic syndrome to define the metabolically healthy obese applied to the various racial/ethnic subgroups by quantifying the number and type of metabolic syndrome components. All women were classified by obesity level and metabolic health status at baseline. The women were thus categorized according to body mass index (BMI, kg/m2) into normal weight (BMI 18.5-24.9 kg/m2), overweight (25-29.9 kg/m2) and obese (30.0 kg/m2) women. Metabolic health status was first defined by presence of the metabolic syndrome (yes/no), and second by number of metabolic syndrome components. In accordance with the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute we defined the metabolic syndrome as any two of the following (criteria for women): increased waist circumference ≥80 cm; increased level of triglycerides ≥150 mg/dL (≥1.7 mM); decreased level of HDL-C <50 mg/dL (<1.3 mM); increased blood pressure with either systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg, or treatment with antihypertensive drugs; and impaired fasting serum glucose ≥100 mg/dL (6.1 mM). Medical Research: What are the main findings? Dr. Schmiegelow: The study population comprised 14,364 women without diabetes or prior cardiovascular disease. The women had a median age of 64 years (interquartile range 57–69), and 47% were white, 36% were black and 18% were Hispanic. Over a median follow-up of 13 years (interquartile range 12–14 years), 1,101 women (7.7%) had a first cardiovascular event. The main findings of this study were that metabolic abnormalities appeared to confer more cardiovascular risk among black women than among white women. Consistent with other studies, among white women without the metabolic syndrome, obesity was not associated with increased cardiovascular risk compared with normal weight women. Conversely, black overweight and black obese women had increased cardiovascular risk compared with normal weight black women without the metabolic syndrome, even in absence of the metabolic syndrome. According to number of metabolic syndrome components, black overweight or obese women with just two metabolic abnormalities had increased risk of cardiovascular disease, although they would be considered “metabolically healthy” based on the standard definition, particularly since one of these abnormalities were abdominal obesity for 79% of overweight and 98% of obese women, irrespective of race/ethnicity. White obese women with three metabolic abnormalities did not have a statistically significantly increased cardiovascular risk compared with normal weight metabolically healthy women. Thus, cardiovascular disease risk appeared to be elevated in black women by the presence of only two or three metabolic abnormalities to a degree that would require four or more metabolic abnormalities among white women. These findings did not appear to be driven by any particular combination of metabolic abnormalities. (more…)
Author Interviews, CDC, Mental Health Research, Occupational Health / 21.05.2015

Dr. Hope M. Tiesman MSPH, PhD CDC, AtlantaMedicalResearch.com Interview with: Dr. Hope M. Tiesman MSPH, PhD CDC, Atlanta Medical Research: What is the background for this study? What are the main findings? Dr. Tiesman: The authors regularly monitor non-occupational injury trends, including the recent and significant increase in suicide rates. This finding led the authors to consider how these non-occupational trends impacted the workplace. We used data for two large national surveillance systems.  We obtained data on workplace suicides from the Bureau of Labor Statistics' Census of Fatal Occupational Injury (CFOI) which compiles data on all fatal work-related injuries in the US.  We obtained data on non-workplace suicides from the CDC's Web-Based Injury Statistics Query and Reporting System or WISQARS. WISQARS data are compiled using national death certificate data.  From here we calculated suicide rates and compared trends across workplace and non-workplace suicides as well as examined the socio-demographics and occupational characteristics of those who chose suicide in the workplace. Several important findings to highlight.  Across the 8-yr timeframe, we found that workplace suicide rates remained relatively stable, even somewhat decreasing that it is until 2007 when a large and significant jump in rates was found.  This was in contrast with non-workplace suicide rates which increased over the entire study period.  Men had signifıcantly higher workplace suicide rates compared to women and generally, as age increased, so did workplace suicide rates.  Those aged between 65 and 74 years had the highest suicide rate of all workers which was also a bit different from non-workplace suicide rates.  Finally, we found that those in protective service occupations, such as police and firefighters, had the highest workplace suicide rates, followed closely by those in farming/fishing/and forestry occupations.  These occupations have been associated with higher overall suicide rates in prior studies.  A somewhat novel finding was that those in automotive maintenance and repair occupations also had significantly higher workplace suicide rates. (more…)